Health insurance enrollments increase in Texas, nationwide

Updated 6:20 am, Thursday, December 12, 2013

Kathleen Sebelius wants an investigation to find what might have contributed to the problems with healthcare.gov.

Kathleen Sebelius wants an investigation to find what might have contributed to the problems with healthcare.gov.

Photo: Gabriella Demczuk / New York Times

Health insurance enrollments increase in Texas, nationwide

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The number of people who chose plans in the health insurance marketplace more than doubled last month to reach nearly 365,000 nationwide, but the Obama administration still lags behind its original forecast of more than 1 million enrollments by the end of November, according to new federal figures released Wednesday.

Spokesmen for the agency overseeing implementation of the Affordable Care Act said improvements to its healthcare.gov website increased insurance plan selections nationwide from about 106,000 in October to 259,000 in November. Initially, the administration hoped to have 1.2 million people enrolled in plans by Nov. 30.

In Texas, between Oct. 1 and Nov. 30, 14,038 consumers picked health plans in the health insurance marketplace. Almost 80 percent of those selections — 11,047 — were made in November.

Elena Marks, Rice University's Baker Institute scholar in health policy, suggested that it will be at least another month before much can be made of the data. In November, healthcare.gov still was flawed, she said. Negative user experiences, bad publicity and outspoken political opposition to the website and health care law might have prevented people from trying to enroll in coverage, Marks said.

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“It's still too early in the game to give much weight in these numbers,” she said. “December will be very interesting because those who want insurance must buy it by Dec. 23 to get coverage on Jan. 1. I think that will be a critical date. It'll be the first time we will have had meaningful numbers.”

Child can get Medicaid

Since the marketplace opened Oct. 1, more than 118,500 Texas residents have completed applications, which would cover nearly 245,000 people when including their families, according to the report. Of these, almost 177,500 are eligible to enroll in a marketplace plan, with about 62,300 applicants qualifying for financial assistance. Almost 7 percent of them were determined to qualify for Medicaid, according to a federal report released Wednesday.

After its release, a steady stream of people moved through a conference room at the Crowne Plaza Houston Hotel near Reliant Park in an event designed to educate and enroll them in marketplace plans. Nearly two dozen application counselors used laptop computers to assist those seeking help.

Karla Hay, 24, spent more than an hour with counselor Nicole Phillips-Watts to create an account, apply for a tax credit and briefly assess nearly 30 plan options. Hay, a stay-at-home mother of a 2-year-old son, said she and her husband, who is self-employed, have a lot to consider before enrolling in coverage. Hay said she was surprised to see so many options from which to choose. But she said she was relieved upon learning that her son qualified for Medicaid.

“It's always been a concern for me,” she said of being uninsured. “But you can't get your wants, when your needs come first. Our son is our main concern.”

Demographics on who has enrolled in or applied for marketplace coverage, including age groups and income levels, was not available.

The website is where residents of 36 states, including Texas, have been directed to buy coverage under the Affordable Care Act. Website flaws prevented millions of people from using healthcare.gov for much of the first two months of enrollment. The goal of the system has been to enroll 7 million people by March.

Spokesmen said they expect numbers to continue increasing as more people use the website or call centers or make appointments to enroll.

“These numbers that we are releasing today are encouraging,” spokeswoman Julie Bataille said. “We expect these numbers to continue to grow over time. They show tremendous demand for this product.”

Sebelius' blog post

After the website's troubled launch, Health and Human Services Secretary Kathleen Sebelius took a beating over problems with the site, with Republican members of Congress calling for her resignation. The Obama administration spent last month seeking to improve the site to ensure that it could handle an estimated 800,000 visitors per day by the end of November.

On Wednesday, Sebelius said in a blog post that she wants her department's inspector general to investigate the contracting process, management, performance and payment issues to determine whether they contributed to healthcare.gov's disastrous launch.

Despite the marketplace's troubled rollout, Michael Hash, director of the Department of Health and Human Services' Office of Health Reform, said the administration has not revised its enrollment projections.

“We think we're on track,” he said of the 7 million sign-up estimate. “The bulk of enrollments will occur near the end of open enrollment.”

The report includes plans selected, but not necessarily completed enrollments.

The number of faulty plan applications that prevented insurers from completing enrollments is unclear. Last week, spokeswoman Bataille said website problems created errors with one of every 10 plan applications sent to insurers. In October, problems occurred with one in four files.

Earlier this week, Bataille said her agency and insurers have been reconciling applications to ensure accuracy and complete enrollments.